'Sexist' labelling of premenstrual distress criticised

Natasha Boddy

A Canberra researcher has criticised a "sexist" move by the American Psychiatric Association to classify a severe form of premenstrual syndrome as a psychiatric disorder.

Dr Tamara Kayali Browne, a bioethicist from ANU's Research School of Biology, said premenstrual dysphoric disorder (PMDD) – a more severe form of premenstrual syndrome – should be deleted from the APA's Diagnostic Statistical Manual of Mental Disorders.

She said PMDD had been classified as a psychiatric disorder in the manual, which is also used in Australia.

It is estimated 2-5 per cent of women suffer from PMDD and Dr Browne said it was sexist and wrong to classify it as a mental illness.

"My concerns are that by treating premenstrual anger or distress as just PMDD, the legitimate concerns that [these women] have could be brushed aside and we might miss an opportunity to deal with what might really be at the root of their anger or stress," she said.

"The experiences of women diagnosed with PMDD are very real, but they shouldn't be classified as a mental disorder and they shouldn't need to be diagnosed with a mental disorder in order for their suffering to be taken seriously and to get help and treatment for it."

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Dr Browne conducted research into studies of women who presented with PMDD that revealed most suffered from abuse or problems with their work or relationships.

"PMDD is usually described as a more severe form of PMS and the symptoms of it include really depressed mood, anxiety, irritability, anger, change in appetite, among other things," she said.

Dr Browne said several studies also found premenstrual anger or distress was related to "household and childcare responsibilities" as well as communication issues between couples.

"Certainly not all women diagnosed with PMDD will be suffering from issues related to life-stress ... but according to these studies, a significant proportion of them are," she said.

Dr Browne's research also found PMDD was not a universal phenomenon, with Western women appearing to suffer from PMS and PMDD more than those in developing countries.

"The other problem with the evidence that's presented for a biological correlation with premenstrual anger or distress is that that evidence hasn't been verified and it pales in comparison to the evidence that it could be related to unfair burdens and circumstances women can find themselves in and the American Psychiatric Association seem to have ignored this sociological evidence," she said.

She was also concerned PMDD would be included as a separate disorder in the upcoming edition of the World Health Organisation's International Statistical Classifications of Diseases and Related Health Problems.